What Are Brachial Plexus Injuries?

Many serious injuries are preventable. Some injuries are a violation of trust. Parents trust that during the labor and birth process, their doctors have the skills and experience to anticipate any emergencies. Your labor and delivery team should be ready to respond as soon as they see that a complication may result in a brachial plexus injury or another birth injury. At Telaré Law, our birth injury lawyers hold physicians and hospitals liable when their negligence causes your infant harm.

The US NIH states that “the brachial plexus is a network of nerves that conducts signals from the spine to the shoulder, arm, and hand. Brachial plexus injuries are caused by damage to those nerves.” Brachial plexus injuries are often due to shoulder trauma, inflammation, or tumors.

The severity of a brachial plexus injury depends on the type of damage to the nerves:

• An avulsion occurs “when the nerve root is severed or cut from the spinal cord.” This is the most severe type of brachial plexus injury.
• An incomplete form of avulsion occurs when the nerve is damaged but there is some chance that the nerve can slowly regain function.
• Neuropraxia, or stretch injury, is the mildest kind of brachial plexus injury.  This condition damages the nerve’s protective covering “which causes problems with nerve signal conduction, but does not always damage the nerve.”

What are the symptoms of brachial plexus injuries?

Symptoms of brachial plexus injuries include:

• An arm that is limp or paralyzed
• Lack of muscle control in the arm, wrist, or hand
• A lack of feeling in the arm, hand, or shoulder
• Severe pain

Usually, just one arm is affected. According to the Mayo Clinic, the most serious brachial plexus injury happens “when the nerve root is torn from the spinal cord.”

Why do brachial plexus injuries happen?

Brachial plexus injuries normally occur when the victim’s shoulder is forced down – while the neck stretches up and away from the part of the shoulder that is injured. According to the Mayo Clinic, “the lower nerves are more likely to be injured when the arm is forced above the head.”

Many brachial plexus injuries happen as a result of a birth injury.  Some of the complications that birth doctors should anticipate include babies who are heavy, prolonged labor, and a baby who presents in a breech position. Brachial plexus injuries may occur if the shoulders of the infant get stuck in the birth canal. If the upper nerves are injured, the condition is called Erb’s palsy.

Other causes of brachial plexus include car accidents, falls, and bullet wounds.

How is a brachial plexus injury diagnosed?

Neurologists and other doctors use the following tests to diagnose a brachial plexus injury:

• X-ray. An X-ray of the neck and shoulder indicates whether there are any broken bones or related injuries.
• Electromyography (EMG). This test involves the placement of a needle electrode through the skin into various muscles. An EMG “evaluates the electrical activity of the muscles when they contract and when they're at rest.” Most people tolerate this test though there may be some pain when the electrodes are inserted.
• Nerve conduction studies. This test involves measuring “the speed of conduction in the nerve when a small current passes through the nerve.” The results of this test indicate how well the nerve is functioning.
• Magnetic resonance imaging (MRI). This test uses radio waves and magnetic fields to show multiple planes of the body including the severity of a brachial plexus injury. The test can also help review the “status of arteries that are important for the limb or for its reconstruction.”
  “New methods of high-resolution MRI, known as magnetic resonance neurography, may be used.”
• Computerized tomography (CT) myelography. This diagnostic test uses a series of X-rays to obtain cross-sectional images of the body. “CT myelography adds a contrast material, injected during a spinal tap, to produce a detailed picture of the spinal cord and nerve roots during a CT scan.” CTs are sometimes used when MRIs don’t provide enough information.

What are the treatments for a Kennewick brachial plexus injury?

Many brachial plexus injuries heal over time, but some injuries may cause longer-term or even permanent injuries. Complications from a brachial plexus injury include:

• Stiff joints. Physical therapy may help.
• Pain. Pain due to nerve damage may become chronic.
• Numbness. A loss of sensation in an arm or hand may mean that a person can burn themselves without knowing it.
• Atrophied muscles. Some nerves cant years to heal. During the healing process, the affected muscles can atrophy/break down.

Even with surgery, some victims with a brachial plexus injury may have permanent muscle weakness or paralysis. Physical therapy helps keep muscles and joints working, prevents stiff joints, and maintains a range of motion.

If surgery is recommended, it normally occurs within six months of the injury. Surgeries outside that time frame have a lower success rate. Some of the types of surgeries for a brachial plexus injury include:

• Neurolysis. This procedure helps to free the nerve from scar tissue.
• Nerve graft. This procedure is used to remove the damaged part of the brachial plexus. The damaged part is replaced “with sections of nerves taken from other parts of the body. This provides a bridge for new nerve growth over time.”
• Nerve transfer. If the nerve root has been torn from the spinal cord, surgeons may take a less essential working nerve and connect it to the nerve that isn’t working. This bypass procedure helps create new nerve growth.
• Muscle transfer. Surgeons who use this procedure remove a less important muscle or tendon “from another part of the body, typically the thigh, transfer it to the arm, and reconnect the nerves and blood vessels supplying the muscle.”

Victims who have pain may experience a “debilitating, severe crushing sensation or a constant burning. The pain usually resolves within three years.” If medications can't manage the pain, surgical procedures to “interrupt the pain signals coming from the damaged part of the spinal cord” may help.

Clinical trials and treatment may be available with local healthcare hospitals or practices.

Who is liable for a brachial plexus injury?

Our skilled medical malpractice lawyers file claims against all negligent healthcare providers. In most birth injury medical malpractice cases, the defendants are the hospital and the labor and delivery team.

Holding doctors and hospitals liable for medical malpractice requires hard work, skill, and experience. At Telaré Law, our Kennewick birth injury lawyers are respected by former clients, insurance clients, and defense lawyers for our strong advocacy and our impressive record of settlements and verdicts for our clients. We demand compensation for all your child’s medical bills, pain and suffering, loss of function, and inability to enjoy life’s pleasures from all liable defendants.

We have offices in Kennewick and Richland, and serve Pasco, Walla Walla, the Tri-Cities and all of Southeast Washington. Individuals and families can schedule an appointment by calling us at 509.737.8500 or filling out our contact form.